Thought Leaders 012 | Dr. R. Wayne Fuqua | Part 2

Shauna Costello (00:00):

You're listening to operant innovations, a podcast brought to you by ABA technologies this month on thought leaders, we're back with Dr. Wayne Fuqua as he answers the questions, where do you see the field going, and or where would he like to see the field go? So I think that's a really good spot to move on to the next questions of, um, and you kind of mentioned this before, but where do you see the field going and or where would you like to see the field go? And you can answer one of those or both of those, or combine them.

Dr. Wayne Fuqua (00:40):

Sure.

Shauna Costello (00:40):

Whatever, however you would like to answer.

Dr. Wayne Fuqua (00:43):

Okay. Um, well let me first start off by saying, where do I see the field going? And the answer to that is very obvious in some level, and that is certainly the demand and the opportunities in the autism area. Um, some people have been a little critical of it, but I've been looking at that as a bridge to popularizing and disseminating behavior analysis and important in, and of its very own right, for improving the quality of life for so many children and young adults on the autism spectrum. So that's an obvious answer right there. That's on of the places that, where the field is going. Uh, but it's not the only place by the way. Um, and I'm really pleased to see some of the work happening in OBM, uh, applying certainly behavioral analytic principles to organizations, to personnel development and training, to improving personnel performance.

Dr. Wayne Fuqua (01:41):

Those are also very important areas. I'm also very pleased to see some of the interesting developments in the behavioral therapy and the first and second and third way behavioral therapy, where the development of acceptance and commitment therapy and the integration of relational frame theory theory into behavioral therapy areas. Uh, so I am just enamored with a notion that behavior analysis, which when I first started in, I had this very, very narrow focus is now funding these applications in so many interesting areas. Um, the other thing that I would also mention here is that, uh, even though I'm enamored with that, there's a lot of room out there for improvement. And as I hinted at earlier, uh, even in the area where we had perhaps the most impact that is, uh, with the autism area, um, boy, there's lots of room for improvement to ensure that people are providing high quality services that are individualized that are effective, that we're tracking the impact.

Dr. Wayne Fuqua (02:48):

We're selecting the right behaviors to have an impact on a person's quality of life. So I still see lots of room there for further improvement, uh, and I want to make sure that we do as well as we possibly can there, because even though we've gotten a lot more acceptance in this particular area, I don't want people going well, that behavioral analytics stuff looked like it wasn't as effective or as wonderful as we thought it might happen to be. So I continue to be interested in how to encourage people in particular BCBAs to do great work. Um, and some of that involves university training to make sure that they're fully prepared to do good work, but a fair amount also involves continuing education, some degree of accountability. And I would love to see more people that are, uh, doing, you know, insurance reimbursement to have some level of accountability.

Dr. Wayne Fuqua (03:43):

I know there was every now and then, you know, some of these awful stories out of, in this particular example of Florida, the BCBAs who were doing fraudulent billing and what's going, how could that ever have happened? That should never have gone on, uh, it should have been detected just like that. If they were doing adequate online, ongoing accountability, that doesn't excuse anybody, by the way, from doing it, it just says, we need to think carefully about how do we continue to ask people to do the very best work possible. Um, so I see a lot of good things happening. I do see one other thing, which I think is really interesting right now, that's going on that I would like to comment on. And that is, I've been quite pleased to see some of the increasing interest on diversity, equity and inclusion and the recognition that we need to be culturally humble, culturally sensitive, as we're designing interventions.

Dr. Wayne Fuqua (04:42):

The part there that I would like to challenge all of us to think about is that, um, too much of the work in this area starts off, and this is a starting point, it was good, saying you need to be aware and aware is one step in the right direction and maybe a baby step, but we need to go well beyond that. We need to be understanding about what, how do you ask about and come to understand cultural factors? How do you take those cultural factors into account as you're communicating and delivering services? And in particular, how do cultural factors map into behavior analytic principles? Do they determine what reinforcers are? Of course they do. Do they determine what behavioral goals might be? Of course they do, 'cause the community determines which behaviors are valued in that community to a certain degree, do they determine how to go about talking about and how to go about changing stimulus value of the therapy delivered?

Dr. Wayne Fuqua (05:49):

And sometimes people have had the intercultural experiences such that they don't get very good experiences and they've had, you know, people are already established as aversive stimuli. So one of the things I'm really interested in doing is getting BCBAs and practitioners, uh, be they by the way, working in autism, behavioral therapy, OBM community, whatever it may be, health psychology to begin to understand how do we think about cultural and diversity issues and how do we adjust our behavior analytic interventions to be what you might call, what I call the ultimate individualized approach to helping people. And by that, what I'm talking about is you need to consider those cultural factors, but you also need to recognize there's remarkable diversity within any given cultural area. You know, all Muslims don't have the same goals. All Catholics don't have the same values. All women don't have the same experiences working through the workforce.

Dr. Wayne Fuqua (06:54):

So you need to begin thinking about, or actually, I should say you, we need to begin thinking about how do you take these unique histories with a cultural lens? How do you learn to ask about them, understand them? And in particular, how do you begin to translate those experiences into the design of effective individualized and culturally sensitive interventions? We have a ways to go there. Uh, but I think that if we begin asking ourselves, how do you go beyond just awareness to understanding these cultural factors and how they influence delivery of services. Now that just scratches one part of the surface, by the way, I would also like to emphasize that we really need to have a behavior analyst involved and understanding racism, sexism, how do we get people more adequately included in economic opportunities? How do we remove health disparities? And I think that behavioral analysis, once again, offers some helpful interventions.

Dr. Wayne Fuqua (08:00):

Now the trouble is, I don't know that we have a good set of empirical interventions available yet, but we really need to understand something about how to, how does bias form, how do we assess it? How do we change bias cause now, right, everybody's talking about doing interventions to do with implicit bias. And the question is, where does that come from? Is it, is bias some kind of like parallel, it's not the same, but parallel to developing a phobia, something a result of the conditioning history, be it a verbal conditioning history or direct experience. And then what interventions might be effective in changing, for example, bias or racial or sexist stereotypes or whatever it may happen to be. Um, and then how do you change those biases, which may be a, kind of almost an emotional and stimulus value function to actually changing behavior so that you treat people fairly in support, just this remarkable range of wonderful diversity we have in our society.

Dr. Wayne Fuqua (09:09):

So, um, I'm really interested in seeing behavior analysis, take that challenge on and be willing to think like a behavior analyst as it relates to all of these major social issues that are facing us. And I've just mentioned diversity, equity and inclusion. That's really an important one, but it doesn't end there. Uh, I would, you know, I'm always very concerned about a whole range of other factors, including things like sustainability. How do we get people to engage in behaviors that will sustain and protect the Earth's environment for others and future generations. And that, by the way, breaks down to be a really difficult behavioral problem as, uh, everything to do with delay discounting, how do you get people to engage in behavior right now that will produce a desirable effect that maybe five years, 10 years, maybe 40 years down the road, who knows when it has a response effort, it may be some immediate costs right now.

Dr. Wayne Fuqua (10:16):

Uh, so those are examples of, um, interesting areas of application that I would like to encourage us to take a look at, and it doesn't end there, by the way, there's just tons and tons of other areas. You know, um, as we begin thinking about how are we dealing with the COVID epidemic, um, at this particular stage, our most available strategies are behavioral, how do you get people to social distance? How do you get them to wear a face mask? How do you encourage them to wash their hands? Uh, and those are behavioral management strategies, which I would point out by the way, are the ones that are most readily available now for managing and containing the epidemic, the spread of the epidemic, but they will not go away. Even if we develop a cure or let's call it a treatment or a vaccine. So those will still be important issues that are operational in that time.

Dr. Wayne Fuqua (11:14):

And then the behavioral challenges will have simply expanded at that time too. So how do you get people to take the vaccine, assuming that it once again, it's safe and is adequately disseminated, how do you get people to monitor and get frequent testing so that if they become infected and there is a treatment that's available, you can get them to initiate treatment as early as possible, thereby reducing the spread of infection to the other people and also reducing the impact it may have on their life. So the bottom line here is that there are so many of the world's problems, and I've mentioned only a few of them. You know, you could, you could keep on going on, you know, uh, um, I've been mentioning racial discrimination, sustainability, COVID, but you can talk about, you know, sexual harassment is also another major issue that I always worry about.

Dr. Wayne Fuqua (12:06):

And that is how do you understand why it is that people harass other people? Uh, and do you then develop interventions that are matched to the motivation? Uh, one of my friends said, you know, there's three types of harassers, the criminal ones that are doing things that are awful, the clueless ones that sometimes genuinely don't know what they're doing, and I would also add in there's sometimes the comedic, those who are thinking they're doing something that's funny, but it's really coming across as harassing. And the interesting question there becomes one of can you match and do you need different interventions depending upon the motivational and controlling variables for the person? So once again, thinking about the parallels with what we call functional assessment and functional analysis, where you try to understand the functions and the controlling variables and the things that enable and provoke in the context for behavior, and then matching intervention to those things.

Dr. Wayne Fuqua (13:09):

So those are the types of expansions of behavior analysis that I would really love to see happening, Now there's, by the way, the areas go on and on and on and on, obviously. Um, and, uh, right now I've never come across anything which I think is, does not have at least some relevance to behavior analysis. Uh, even if we don't have any well-developed and well articulated interventions, sometimes by the way, just starting with a good conceptual analysis. And what's possible is a step in the right direction. Uh, but it needs to be then followed up with people, even taking baby steps to try to evaluate interventions. And this links into something that's bigger than behavior analysis to a certain degree, the whole idea of evidence based science informed, uh, interventions. And one of the things that has been from my perspective really interesting to see is the strong emphasis on evidence based interventions, um, that cut across so much of medicine, social work, occupational therapy, and now psychology and behavior analysis.

Dr. Wayne Fuqua (14:21):

And when I go back and I take a look at the interventions that have been identified as empirically supportive, which is slightly different than evidence-based, but empirically supported interventions, boy, every one of those has behavior analytic principles clearly articulated, or when you look at it a little more carefully, it clearly has learning principles written all over the interventions. So I'm just very enthused to that sort of emphasis on evidence-based empirically supported interventions. But now let me also tell you that we need to go further than that still. And I'm sorry that I sound like I'm a repeating record to a certain degree. I'm proud of what we've accomplished, but want us to accomplish more and more and more. And one of the ways where I think we need to accomplish more and more and more is to recognize that sometimes interventions that we think are going to work don't work.

Dr. Wayne Fuqua (15:19):

In other words, we sometimes end up with treatment failures and this, by the way, cuts across all of science. Even in medicine, you have some times non-responders and adverse responders to pharmacological intervention. Sometimes even in science, you have things we think we know that you've tried to go back and replicate and you don't get it replicated. Now that's happened in some areas, medicine and social psychology, much more so than it has happened to behavior analysis. And I can tell you the reason I think that has happened more in other areas is because many of those other areas rely on what they call the gold standard of research, which is randomized control trials, where you look to see whether your intervention group and your control group differ at a statistically significant level. And if you get the 0.05, you go magic. Well, the trouble with that is, is that that's in some ways an arbitrary criteria, and that gets you to say, this is really an effect, but remember, even at 0.05 there's treatment failures in there and as possible, by the way that the next time you come back and replicate that experiment, maybe you don't get to 0.05, you get to 0.10, and you don't have something there.

Dr. Wayne Fuqua (16:35):

So sometimes it's almost a result of the research model that we come up with. And that's not to say that behavioral analysis strategies are completely immune to that. But when you have daily repeated measures and you have multiple samples of behavior pre and post intervention, and you can see the change and you build in reversals and delayed interventions, you've reduced that to a certain degree from my perspective. So that's a long way of saying essentially that, um, we need to be thinking carefully about how do we make our interventions even more effective? How do we detect if we have a treatment failure? And if we do have a treatment failure, what are our strategies for coping with that treatment strategy failure? Do we go back and do we look carefully at our reinforcers we're programming, which is probably the best way to start, obviously, uh, are they still reinforcers?

Dr. Wayne Fuqua (17:33):

Do we need to establish them through some other pairing and operational procedures as effective reinforcers? How do we look at things that might interfere or are there other competing variables and competing behaviors? Are there other biological things that are getting in the way of treatment gains or even biological things that are getting in the way of the efficacy of a reinforcer? Uh, because you know, reinforcers are transient. They go up and down all the time that breaks our establishing operations, motivational operations. So we need to really have a, almost a protocol for what happens. How do you assess whether or not you're really reducing the effects you want and what do you do if it turns out you aren't producing the effect, essentially. So we need to have a little better effort to assure that everybody that's getting behavioral interventions produces significant gain. That gain is meaningful from a social significance perspective and into quality of life perspective.

Dr. Wayne Fuqua (18:32):

It could be maintained by contacting some sort of ongoing contingencies in the real world, or those contingencies can be programmed. And if you aren't producing the gains, what do you do about it? And, you know, I, I've never seen much in the way of adverse effects like you sometimes get in the pharmaceutical area, but we need to also be aware that, you know, we could have adverse effects. Sometimes people who not only don't show the gains, but have an adverse effect of being in, participating in a behavioral intervention. So we just need to be really sensitive to those particular issues. Um, so those are the, some of the major challenges I would love to see us dealing with. I will say that, uh, um, this is going to be overstated a little bit. Um, I think that what we have in terms of basic principles, we're going to continue to see those tweaked and refined. Maybe I'll be surprised and we'll find major new advances in terms of basic principles, love that if it happened, but you know what we have right now, I think our biggest challenges, how do you apply them? How do you base a disseminatable science? I think that's a word or disseminable one of the two on a, um, on the principles we have and how do you get people, not just behavior analysts, but everybody this involved in dealing with behavior, be it physicians, nurses, occupational therapists, all those folks to be more, uh, evidence-based and, and begin to incorporate behavioral analytic principles into their delivery of services. So, uh, I wish I had about another 200 years of life ahead of me, cause I'd love to see what is happening there, but I know I won't. So, uh, I'm hoping that the next generation of dedicated behavior analysts and behavioral scientists will take up some of those challenges. And I would love to, you know, come back let's hope I live another 20 years or whatever, 25 or 30 years who knows and say, wow, look at all the phenomenal progress that has happened. The expansion into new areas, the improvement in the overall efficacy and efficiency, behavioral procedures, and maybe even the expansion of our fundamental understanding. And I think there's, you know, room there quite honestly. Um, and, uh, I think sometimes it's really interesting for us to read even outside the mainstream behavior analysis research area.

Dr. Wayne Fuqua (21:06):

And, uh, um, and I do that frequently. And one of the books that I'm reading right now is a book called Presuasion and I'm going to try and get the guy's name, right? I'm gonna miss it, Cialdini or Cialdini or something like that, please forgive me if someone hears this, uh, look up the book Pre-Suasion, uh, and, uh, but he talks about interventions ahead of time, antecedent interventions that mostly in the advertising area, but not always, but anything that changes behavior and advertising, by the way, sometimes changes behavior, at least the behavior of initially trying something. And then sometimes once you tried something, you contact the reinforcing consequences and maintain that behavior, but he talks about all these different strategies where people, uh, antecedent interventions might be more or less effective for getting people to try out certain behaviors and to change the stimulus value of certain things as we're going along.

Dr. Wayne Fuqua (22:03):

And some of these things will be really important as you're doing like community public health advertising, or trying to get to people to engage in sustainable behavior with large scale community interventions and things of that nature. So I am certainly thinking that if we have something regardless where the science is or what science it is, if it looks like it's producing reliable changes on behavior then it is incumbent on behavior analyst to pay attention to it and to try to understand the behavioral principles that are involved, or if they can't identify those behavioral principles to say, we must've missed something, let me go back and figure it out. This is going to be something new for us, perhaps, but to begin to incorporate as many things from as diverse an area as possible into an ultimately effective and all encompassing kind of science of behavior, as it pertains to whatever the concerns might happen to be, be it autism or mental health or public health or environmental sustainability or ethical behavior. So those are some of the tiny things that I would love to see us accomplish in the next decade or two or three.

Shauna Costello (23:18):

Well, I think that this is a good time to kind of mention to your, your grad lab, you know, my experience with it, you do a really cool kind of amalgamation of stuff. You don't just take straight behavior analytic students. You also have clinical students as well. And the types of research that you know, that I know of that was coming out of your lab was very diverse and very, and I think that that kind of speaks, reinforces what you've been saying. You're, you're not just saying it to say it, you practice this all of the time and you practice this with the students that you brought in to your graduate lab as well.

Dr. Wayne Fuqua (24:06):

Absolutely. You know, my, my lab is not just a behavior analysis lab or a clinical lab, or we've even done some OBM stuff out of there also, um, it's a lab that says let's take any problem, any challenge, anything you're interested in and ask how behavior analysis can help understand or address that. And over the years, I've had, you know, all kinds of interesting, wonderful students coming through that have been interested in everything from recycling, environmental sustainability, to gambling, to autism. How do you do a functional analysis to eating disorders, to depression issues, to sleep disorders? So it cuts across the spectrum. And, um, I, I don't know, in some ways I probably would have had much more impact had I stayed in one particular area of work that, uh, but I've really loved the diversity and the notion that what part of my mission has been is to help people to figure out how does behavior analytic principles apply to just about everything under the sun. And, uh, I think it adds value regardless where you are, what your ultimate mission might happen to be in life. So, uh, and once again, I certainly give credit to all these wonderful, fantastic graduate students and colleagues that I've had. And, uh, you know, we're all part of the context, you know, and those have been important parts of my context. They've challenged me that educated me. Uh, they've helped me expand my repertoire and my sense of understanding about how behavior analysis applies in so many areas.

Shauna Costello (25:44):

Well, in, I mean, you even brought up when we were talking about sustainability and even the COVID some of the COVID stuff that's going on right now, these altruistic behaviors and how we get people to do that. But you also practice that as well. Like you said, you're like, maybe I should have just stayed and focused on one thing, but kind of how I see it is it's kind of altruistic how you handled your lab. You're not just you're doing it for like, yeah, you're spreading out all these different topics and research subjects that you're looking to, but that's for like the future it's for others. And you're all these grad students are now going out and doing all of this different stuff, that's going to impact multiple different areas. And then, I mean, they're learning their mentorship from behaviors from you, which is then hopefully going to, they're going to do that with their students as well. And so I can kind of see it as again, you're practicing what you preach is this altruistic behavior of no, it's not just about me and my interests and my publications. You're doing what your students are interested in that's spread, that's, it's a very wide array of research that will hopefully end up impacting multiple different areas.

Dr. Wayne Fuqua (27:10):

And that is a good point, you know, and I, by the way, I hope that all my students pick up on the good mentoring behaviors that I've done and ignore correctly, the not so good mentoring behaviors I may have done over the years, but you know, the really early in my work at Western Dick Malott says something to me, I thought was really interesting. He said, whatever you do, don't mess with people's reinforcers. And what that said to me is, you know, if you have someone that something is reinforcing to somebody, you don't try to negate it or make it so it's not that, you take advantage of that. And if someone was interested in eating disorders, for example, or already interested in autism are already interested in whatever reason, um, sustainability issues, help them pursue those interests, because those are already established reinforcers.

Dr. Wayne Fuqua (28:01):

Now that's not to say that sometimes we don't develop reinforcers over the course of our lifetime. You know, it didn't take me long reading about sustainability issues to go, oh my gosh, this is perhaps the most serious threat to the wellbeing of the planet that we've ever had. Um, so that became a reinforcing topic for me to read about and do something well, not to read about it. It's difficult reading about some of these topics to a certain degree, but it became important for me to say, well, what can we do about it and how do we talk about it and how do we make this problem situation a little bit better? So, uh, yeah, it's really important to kind of take all this diverse areas of interest and try to support people as they're moving into whatever their niche is going to be in this bigger scheme of things and whatever their niche is and goals might happen to be for their life and help them achieve those goals.

Shauna Costello (28:53):

Yeah, and I really like hearing that. I mean, just going back to everything, it's just been really neat to hear your history because, you know, I was only at Western for a handful of years for undergrad and grad, um, and only, you know, got to, I got to interact with you a little bit, but at the same time, it's like even, you know, just having those interactions with you and now hearing your history and your experiences. It's, it's, it's just really neat to see, you can see this behavior analysis, our history, our learning history to where you are now and it's yeah, it's just, I, I loved hearing, I loved hearing your story.

Dr. Wayne Fuqua (29:38):

Well, good, good. Well, I hope it was not completely boring and hope it was fairly interesting. I don't know how it compared to other people who've done talks and stuff like that.

Shauna Costello (29:46):

No comparison, no comparison. Everyone, everyone's has been very different and unique. I mean, there's some like small, there's always like those small, um, consistencies kind of like the, how you found behavior analysis, you kind of like fell into it. Um, and kind of same thing with you. You're like, okay, I'll take one more class. Um, but no, I, I can't even compare all of them because they're all also different, but it's just really neat to see how each person has where they came from and where they are now and that journey that got them there. And I'm just hoping that that can show some of our newer behavior analysts that you're not stuck, 'cause sometimes I even feel stuck and, but you're not stuck. Um, and hopefully this gives some, this change of some motivations of individuals to kind of hopefully reach out into other areas. Or if something's interesting to you go do it because if it doesn't work, that's okay. You gave it a shot. Um, but yeah, just hearing all of these stories has been great motivation for me. So I can just hope it's the same for other people, but I mean, thank you again so much. Um, it's been great talking to you again. Um, and yeah, I mean, stay safe.

Dr. Wayne Fuqua (31:20):

Same to you, keep us posted as to what you end up doing. I'm expecting wonderful things from you.

Shauna Costello (31:26):

Thank you for listening to this episode of thought leaders. And as always, if you have questions, comments, feedback, or suggestions, please feel free to reach out to us at operantinnovations@abatechnologies.com.